


Operating the Winter Soldier: An abbreviated handbook

by spiderfire



Category: Captain America - All Media Types, Marvel Cinematic Universe
Genre: Abuse, Dehumanization, Drug Abuse, Emotional/Psychological Abuse, Gen, Hydra (Marvel), Medical Inaccuracies, Medical Jargon, Medical Torture, Non-Consensual Drug Use, Psychological Torture, References to Drugs
Language: English
Status: Completed
Published: 2015-07-26
Updated: 2015-07-26
Packaged: 2018-04-08 11:37:10
Rating: Teen And Up Audiences
Warnings: Graphic Depictions Of Violence
Chapters: 2
Words: 1,155
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/4303410
Author URL: https://archiveofourown.org/users/spiderfire/pseuds/spiderfire
Summary: <blockquote class="userstuff">
              <p>Two excerpts from the Winter Soldier Handbook: deactivation and a page of the drug chart.</p>
            </blockquote>





	1. Chapter 4 - Cryogenic suspension

**Author's Note:**

  * For [Lunarium](https://archiveofourown.org/users/Lunarium/gifts).



> Over a decade ago, I was an EMT-B. This fic pieces together what I remember from that, plus a very generous dose of wikipedia. If you are a doctor or someone with actual medical training, please don't break something laughing at my mistakes. Corrections will be gratefully accepted.
> 
> I did the best I could with the HTML. I hope it is readable enough! Suggestions on improving the formatting are also gratefully accepted.

**Summary for the Chapter:**

> Chapter 4 Section 8 - Cryogenic deactivation

1\. Subject must have no injuries. Refer to the Recovery Chart in section 6-18 for guidelines. 

2.Perform standard pre-deactivation maintenance for external prosthetic device as described in section 8-22.

3.If cognitive integration has occurred during the activation, or if activation required the imprint of a particular persona, subject should be mind-wiped and given a standard imprint 24 to 48 hours prior to deactivation. Wiping without proper imprinting decreases rate of recovery on reactivation by 60%. See Chapter 11.

4.Fast subject (fluids and solid food) for 24 hours prior to deactivation. After 12 hours, subject may complain of cephalagia or presyncope. Administer an appetite suppressant such as a low dose of C9H13N-left, also labeled as Levo, as needed.

5.Does with a high dose of laxative and diuretic agents 12 – 24 hours before deactivation. Dehydration decreases risk of crystal growth during storage. 

6.Subject may be sedated or given a semi-paralytic agent prior to deactivation if cognitive integration is preventing compliance. Under no circumstance should physical punishment be applied within 12 hours of deactivation.

7.The subject may be rewarded with recorded music for compliance.

8.2 hours aerobic activity 4-6 hours prior to the initiation of the cryogenic deactivation increases the rate of recovery upon reactivation by approximately 50%. Subject may resist aerobic activity due to fasting, but withholding 47-Hal and applying C10H15N-right (Dex) and epinephrine through a transdermal patch will stimulate sufficient movement.

9.During this time, the subject should be oriented x3. If Beta-complex was given within 12 hours, usually as per mission parameters, the subject may experience hallucinations and confusion if the anti-psychotic 47-Hal is withheld. _Baseline responses_ :

a. Who are you? _No answer if the standard imprint holds._

b. Where are you? _Should be correct, as per standard imprint._

c. What year is it? _Should be correct, as per standard imprint._

d. What just happened? _The subject should be able to describe the immediate past activity – exercise, exam, etc._

10.Dose with BZD-867 15 minutes prior deactivation. Use even if the subject is unconscious. This temporarily converts the amnesic state from retrograde source to anterograde, preventing the subject from making permanent memories about the cryogenic procedure.

a.If conscious, test for efficacy by using the following free association:“ _Glenn_ ”, “ _Jitter_ ” and “ _Steve_ ”. If he responds “ _Miller_ ”, “ _bug_ ” and “ _Rogers_ ”, proceed. If the response differs from baseline, re-dose and repeat the test in 15 minutes.

b.Once BZD-867 takes effect the remaining steps must be completed within 15 minutes before the amnesia type reverts to retrograde.

c.Once BZD-867 takes effect the subject’s orientation will decrease to x1.5. _Baseline response_ :

i.Who are you? _James Barnes, 32557038_

ii.Where are you? _No answer_

iii.What year is it? _1944_

iv.What just happened? _No answer_

d.Once the BZD-867 takes effect the subject will express confusion and ask about Steve Rogers. It does not matter what you say at this point. Speak softy and reassure him as you work. You may tell him that Steve is coming back or that Steve asked him to cooperate or that he’s going to be okay and Steve will be there when he wakes up. Tell him he did a good job. Tell him that the world is safer because of his work. 

11.The prosthetic device should be fully deactivated before cryogenic suspension is initiated as described in Chapter 8.

12.Administer high does Z-complex. Subject’s orientation level will decline to x1 and he will only respond to the first question. 

13.If conscious, the subject should position himself in the cryochamber. **Warning** : Once the prosthetic is deactivated, the subject experiences disequilibrium. Stabilization assistance must be provided.

14.Apply EKG patches, core temperature monitor, relays to internal implants and blood transfusers. Blood transfusers should be applied to the jugular and femoral veins. There will be profuse bleeding at the ports for approximately 30 seconds. 

15.Blood transfusers greatly increases the rate and homogeny of cooling and prevent large crystal growth. Reactivation is 83% more rapid if no ice crystals larger than 0.001 m have been allowed to grow. 

16.Administer Type III antifreeze protein and an anti-coagulant such as _Haementeria ghilianii_ extract after wounds have healed around the transfusers. 

17.Activate chamber. Subject may panic as the restraints lock and the lid closes. Orientation level may increase briefly. This is typical. 

18.Standard core temperature decrease is 6 C per minute. If the cooling rate is less than 6 C per minute, involuntary nervous system reactions may damage subject. If it is faster than 6 C per minute, cooling may not be uniform. 

19.Subject may be agitated and shiver violently for first 70 seconds. Osborn waves will appear between 50 and 60 seconds. Agitation will cease between 70 and 90 seconds.

20.Subject will loose consciousness at approximately 180 seconds after cryogenesis. At this point, the subject’s heart rate will be less than five beats per minute. Subject will enter asystole between 180 and 240 seconds. 

21.Active transfuser pumps are recommended to maintain core temperature at sub zero temperatures and prevent crystal formation. However, as cryogenic procedures in the ‘40s and ‘50s did not include these technologies and the subject survived, they are not required if cryochamber transport is necessary. Transfusers reduce reactivation time to less than 24 hours, instead of 72 to 96 hours if small crystal growth occurs or 140 to 170 hours if larger crystal growth occurs. 

22.Maintain core temperature at -5.9 C.

23.Subject may be reactivated after 200 hours. Subject should not be kept deactivated for longer than 50,000 hours.


	2. Partial drug chart

**Drug name**

| 

**Use**

_*indicates cleared for field administration_

| 

**Effects**

| 

**Side effects on typical subjects**

| 

**Observed side effects on subject**  
  
---|---|---|---|---  
  
_BZD-867_

| 

prior to memory modification 

prior tocryogenic deactivation

| 

Converts retrograde source amnesia to anterograde amnesia

Inhibits use of Winter Soldier-specific training. 

Prevents the formation of new memories

Minor sedative 

| 

imbalance

ataxia

slurred speech

respiratory depression

| 

Induces hallucinations, sometimes violent

_Use with anti-psychotic such as 47-Hal_  
  
_Beta3_

| 

For anti-anxiety. 

Administer prior to deactivation and memory modification.

* (low dose) Increases accuracy of long distance marksmanship

| 

Dampens stress response

| 

Nausea

Bronchospasm

Nausea

Heart failure

Edema

| 

Vivid dreams Nightmares

Hallucinations

Dyspnea

Bradycardia

_Use with anti-psychotic such as 47-Hal_  
  
_TCA-622_

| 

*Chronic neuralgia 

*Phantom neuromas

| 

Reduces chronic pain associated with amputation and implants

| 

Cardiotoxicity

Myocardial irritability

Nausea

Vomiting

| 

Akathisia

Constipation

Urinary retention  
  
_Z-complex_

| 

Use in conjunction with BZD-867 prior to deactivation. 

*May be used as a sleep aide

| 

Sedative

| 

Withdrawal

Liver cirrhosis 

| 

Amnesia

Hallucinations

Fugue state

_Use with anti-psychotic 47-Hal_  
  
_47-Hal_

| 

*Anti-hallucinogen

_Use in conjunction with Z-complex, Beta3 and BZD-867._

| 

Suppresses hallucinations, fugue state and nightmares

| 

Tardive dyskesia

Muscle rigidity 

Autonomic instability 

QT Prolongation

| 

None  
  
_C9H13N-left_

| 

Increases wakefulness and alertness

(Low dose) Appetite suppressant

| 

Stimulant

| 

Hypertension

Tachycardia

Vasoconstriction

Nausea

Withdrawal

| 

Tremors

Restlessness

Explosive Disorder

Psychosis  
  
_C10H15N-right_

| 

*Increases wakefulness and alertness

Anti-depressant

| 

Stimulant

| 

Neurotoxicity

Cerebral hemorrhage 

Rhabdomyolysis

Death

| 

Sexual arousal

Withdrawal

Extreme appetite suppression

Explosive Disorder

Psychosis  
  
**Notes for the Chapter:**

> (happy dance for getting the table to have borders!)


End file.
